【摘要】 目的 :研究四川省男性慢性肾功能不全病人性功能障碍的发病情况、表现形式和相关因素。　方法 :多中心合作、临床横断面调查 ,利用性功能电脑测评与诊断系统 (SCASF) ,对四川省 12 4例慢性肾功能不全病人和 12 5例慢性肾脏病肾功能正常病人 (对照组 )的性功能状态进行综合评价 ,同时测定其血常规、肾功能、性激素、性激素结合球蛋白等指标。　结果 :①慢性肾功能不全病人性功能障碍主要表现为性欲减退、勃起功能障碍 (ED)、早泄。②慢性肾功能不全病人性欲减退、ED、早泄、性操作焦虑、性合作缺乏的发生率明显高于对照组 (P <0 .0 5 )。③血液透析和腹膜透析病人各种形式的性功能障碍的发生率和障碍的严重程度没有差异 ;透析组 (血液透析和腹膜透析 )、未替代治疗组、肾移植组比较 ,未替代治疗组性欲减退和性操作焦虑的发生率高于透析组与肾移植组 ;未替代治疗组和透析组ED的发生率高于肾移植组。④多因素分析表明 ,性功能障碍的发生与病人的病程、肌酐清除率、甲状旁腺激素、血浆白蛋白无关。贫血、抑郁和应用 β受体阻滞剂是性欲减退的危险因素。年龄增加是ED的危险因素。应用血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂和应用人基因重组促红细胞生成素 (r HuEpo)可减少ED的发生。　结论 :男性慢性更多还原

【Abstract】 Objectives: To investigate the prevalence,main manifestation and related factors of sexual dysfunction in male patients with chronic renal insufficiency (CRI). Methods: A cross section study was conducted by six hospitals in Sichuan Province. The prevalence and severity of sexual dysfunction were assessed by SCASF microsoft among patients with chronic renal disease. Logistic regression was used to examine and test the association between sexual dysfunction and other medical conditions. Results: The prevalence of sexual dysfunction was wider in patients with CRI than in those without. The main manifestations in male patients were decreased libido, erectile dysfunction and premature ejaculation. Stratified analysis in uremia showed that the prevalence and severity of sexual dysfunction were similar between patients on haemodialysis(HD)and those on peritoneal dialysis(PD). The patients receiving no replacement treatment suffered more decreased libido and performance anxiety than dialyzed patients (HD and PD) and transplantation patients(Tx). The patients receiving no replacement treatment and dialysis suffered more erectile dysfunction than Tx men. A multivariable analysis demonstrated that the duration, creatinine clearance(Ccr), parathyroid hormone (PTH), albumin(Alb) were not associated with sexual dysfunction. The use of β blocker, anemia and depression were risky factors for decreased libido, and increasing age was a risky factor for erectile dysfunction. The use of angiotention converting enzyme inhibitor(ACEI)/angiotention receptor antagonist(ARB) and recombinant human erythropoietin(r HuEpo) were protective factors for erectile dysfunction. Conclusions: The main manifestations of sexual dysfunction in male patients with CRI are decreased libido, erectile dysfunction and premature ejaculation. The replacement therapy, especially transplantation, can decrease the prevalence or severity of sexual dysfunction. The genesis of sexual dysfunction is multifactorial, including age, physiological factors, psychological factors and medical conditions.更多还原